Oral nutritional supplementation increases caloric and protein intake in peritoneal dialysis patients

Background. Malnutrition is highly prevalent in peritoneal dialysis (PD) patients and is associated with a poor prognosis. Attempts to improve nutritional status with enteral supplements have yielded poor results. Methods: We performed a crossover-design trial on 13 PD patients to investigate whether these patients reduce their food intake after drinking oral nutritional supplements. Patients attended three visits in which they were administered a standard oral nutritional supplement either 2 hours or 30 minutes before lunch or a placebo drink 30 minutes before lunch. Lunch was provided as a self-select buffet-style meal, and food intake was measured. Total intake was calculated by adding the nutritional content of the oral supplement. Results: Patients showed poor food intake, with mean values equaling only 18% of the recommended daily intake for calories and 34% for protein. Drinking the supplement 2 hours before lunch resulted in a significant increase compared with the placebo visit in total caloric (430 to 843 kcal; P < 0.001) and protein intake (27.6 to 41.3 g; P = 0.006). No significant difference in total intake was detected between drinking the supplement 2 hours versus 30 minutes before lunch. Conclusion: These results indicate that oral nutritional supplements administered before a meal may significantly increase caloric and protein intakes of PD patients.